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People with learning disabilities still face inequalities in access to health services. This article, which comes with a handout for a journal club discussion, sums up what nurses can do to reduce these inequalities

'Understand what Francis means for your practice'

The day the Francis report came out, if you asked anyone what they thought of it, they’d say: “Long, and too many recommendations.”

Now the dust has settled, a week or so on, and if you ask someone what they think of the report, their response is more considered. They pause before saying: “Long, and too many recommendations.”

The truth is “fixing” the NHS was never going to be a simple 10-point plan. Every area of the organisation needed to be examined.

Just last week we heard Stephen Dorrell, chair of the Commons Health Select Committee, describe the culture as “corrupt” on BBC Radio 4’s Today programme, when it featured an interview with Gary Walker, the former NHS chief executive who it claimed was the first whistleblower ever to break the terms of his gagging contract. Meanwhile, 14 hospitals are being investigated for unusually high mortality rates and nurses continue to tell us their wards are dangerously understaffed.

So, yes, there is a long to-do list to put right the ills of the NHS. And I would imagine it will take the chief nursing officer for England Jane Cummings and director of nursing at the Department of Health Viv Bennett some time to unpick the report and work out what must become policy and practice for nursing.

But this should actually be the job of all nurses. The Francis report is a chance to stop and take stock. If nurses don’t examine the recommendations and have debates about the findings, then we will have squandered £13m - and a golden opportunity.

Everyone in the profession has a responsibility to be familiar with what Robert Francis QC said about nursing. Certainly, nearly 3,000 nurses who took part in our post-Francis report survey welcome the recommendations. Supernumerary ward sisters, healthcare assistant regulation and key nurse workers are some of the popular things from Francis’ list.

In our practice pages, we have already started pulling out some of Francis’ new key findings. We’ve looked at several issues, including those of privacy, dignity and continence care. Over the coming months we will continue to publish articles that will help you to think about what this report should mean to your practice.

Francis must be the start of the new NHS. Examine what needs to be kept, and be brave in challenging that which is not helping the service attain its best. Changes must take place all over the NHS, but nursing must claim its share of the responsibility.

Ward managers should be incentivised to stay at the bedside rather than being forced to choose administrative roles if they want to progress their careers, according to the government’s former older people’s tsar.

Robert Francis QC found the terrible experiences reported by patients and relatives at Mid Staffordshire Hospital “came largely from wards lacking in strong, principled and caring leadership”.

Readers' comments (3)

Anonymous19 February, 2013 7:10 pm

'If nurses don’t examine the recommendations and have debates about the findings, then we will have squandered £13m - and a golden opportunity.'

'Everyone in the profession has a responsibility to be familiar with what Robert Francis QC said about nursing.'

I couldn't agree with you more. However, what I am finding is that even some very senior nurses don't see it as their personal responsibility, but instead, prefer to wait to see what their organisation says. For me, this misses the point entirely. We now have a report that backs up much of what we have been saying for years and if we combine this with the values of our national nursing strategy, we have some very powerful weaponry to fight the war against the very things we believe are harming patient care.

This is our chance to fight back and if we don't take it, it will be as criminal as some of the things in the Francis Report itself.

Others may find this a bit strong, but I'm a firm believer that together we can be much more powerful, especially if we put our energy into doing the right thing, take responsibility and stop trying to put the blame on those visible leaders at the top. We have all played our part, aided and abetted by the culture of fear driven out from the Centre and by politics.

I do hope that when action points are considered that the opinions of all front line health workers are seriously considered without bias for they have the key to remedying many of the failings pointed out in the Francis Report.

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